Shivdas Sachin, Hashim M S, Ahmad T Sara
National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, University of Malaya, Kuala Lumpur, Malaysia.
J Orthop Surg (Hong Kong). 2018 May-Aug;26(3):2309499018802504. doi: 10.1177/2309499018802504.
Our primary objectives were to create a reliable, noninvasive method for three-dimensional morphometry of deep bony parameters within the sigmoid notch of the distal radius, to identify its morphological patterns, and to identify any significant variation between the left and the right wrists. Our secondary objectives were to obtain morphometric values that could represent our population and to identify any possible ethnic variations.
Computed tomography scans of 102 wrists from 51 healthy individuals were analyzed using a virtualization software. Four anatomical parameters at the distal radius sigmoid notch, namely, the radius of curvature, depth, version angle, and sagittal slope were measured. Morphological patterns of the sigmoid notch surface were identified. The results were statistically analyzed to assess the reliability of the technique and were compared with previously published literature.
Comparing our findings with previously published values, our study revealed a slightly larger radius of curvature and sagittal slope, while revealing a smaller depth and version. We identified the S-type, C-type, and ski-slope morphological variants. The flat-face morphological variant, however, was not identified. The sigmoid notch at the left and right wrists were similar, except for the radius of curvature.
This study demonstrates a noninvasive, fast, reliable, and reproducible technique for analyzing the sigmoid notch of the distal radius. In wrist injuries with intact distal radius sigmoid notch but involving comminuted fractures of the ulnar head, ulnar head replacement may be indicated. In such cases, analysis of the ipsilateral intact sigmoid notch would allow us to prepare an ulnar head prosthesis of appropriate size.
我们的主要目标是创建一种可靠的、非侵入性的方法，用于对桡骨远端乙状切迹内的深部骨参数进行三维形态测量，识别其形态模式，并确定左右腕之间的任何显著差异。我们的次要目标是获得能够代表我们研究人群的形态测量值，并识别任何可能的种族差异。
使用虚拟化软件对51名健康个体的102个腕部的计算机断层扫描进行分析。测量桡骨远端乙状切迹的四个解剖参数，即曲率半径、深度、翻修角度和矢状斜率。识别乙状切迹表面的形态模式。对结果进行统计分析以评估该技术的可靠性，并与先前发表的文献进行比较。
将我们的研究结果与先前发表的值进行比较，我们的研究显示曲率半径和矢状斜率略大，而深度和翻修角度较小。我们识别出了S型、C型和滑雪坡形态变体。然而，未识别出平面形态变体。除曲率半径外，左右腕的乙状切迹相似。
本研究展示了一种用于分析桡骨远端乙状切迹的非侵入性、快速、可靠且可重复的技术。在桡骨远端乙状切迹完整但涉及尺骨头粉碎性骨折的腕部损伤中，可能需要进行尺骨头置换。在这种情况下，对同侧完整的乙状切迹进行分析将使我们能够制备合适尺寸的尺骨头假体。
